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First do no harm - interventions during labor and maternal satisfaction: a descriptive cross-sectional study

BACKGROUND: Interventions can be lifesaving when properly implemented but can also put the lives of both mother and child at risk by disrupting normal physiological childbirth when used indiscriminately without indications. Therefore, this study was performed to investigate the effect of frequent in...

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Autores principales: Çalik, Kıymet Yeşilçiçek, Karabulutlu, Özlem, Yavuz, Canan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6201531/
https://www.ncbi.nlm.nih.gov/pubmed/30355293
http://dx.doi.org/10.1186/s12884-018-2054-0
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author Çalik, Kıymet Yeşilçiçek
Karabulutlu, Özlem
Yavuz, Canan
author_facet Çalik, Kıymet Yeşilçiçek
Karabulutlu, Özlem
Yavuz, Canan
author_sort Çalik, Kıymet Yeşilçiçek
collection PubMed
description BACKGROUND: Interventions can be lifesaving when properly implemented but can also put the lives of both mother and child at risk by disrupting normal physiological childbirth when used indiscriminately without indications. Therefore, this study was performed to investigate the effect of frequent interventions during labor on maternal satisfaction and to provide evidence-based recommendations for labor management decisions. METHODS: The study was performed in descriptive design in a state hospital in Kars, Turkey with 351 pregnant women who were recruited from the delivery ward. The data were collected using three questionnaires: a survey form containing sociodemographic and obstetric characteristics, the Scale for Measuring Maternal Satisfaction in Vaginal Birth, and an intervention observation form. RESULTS: The average satisfaction scores of the mothers giving birth in our study were found to be low, at 139.59 ± 29.02 (≥150.5 = high satisfaction level, < 150.5 = low satisfaction level). The percentages of the interventions that were carried out were as follows: 80.6%, enema; 22.2%, perineal shaving; 70.7%, induction; 95.4%, continuous EFM; 92.3%, listening to fetal heart sounds; 72.9%, vaginal examination (two-hourly); 31.9%, amniotomy; 31.3%, medication for pain control; 74.9%, intravenous fluids; 80.3%, restricting food/liquid intake; 54.7%, palpation of contractions on the fundus; 35.0%, restriction of movement; 99.1%, vaginal irrigation with chlorhexidine; 85.5%, using a “hands on” method; 68.9%, episiotomy; 74.6%, closed glottis pushing; 43.3%, fundal pressure; 55.3%, delayed umbilical cord clamping; 86.0%, delayed skin-to-skin contact; 60.1%, controlled cord traction; 68.9%, postpartum hemorrhage control; and 27.6%, uterine massage. The satisfaction levels of those who experienced the interventions of induction, EFM, restriction of movement, two-hourly vaginal examinations, intravenous fluid, fundal pressure, episiotomy, palpation of contractions on the fundus, closed glottis pushing, delayed umbilical cord clamping, delayed skin-to-skin contact, fluid/food restriction, and of those who were not provided pharmacological pain control were found to be lower (p < 0.05). CONCLUSION: Medical interventions carried out at high rates had a negative impact on women’s childbirth experience. Therefore, a proper assessment in the light of medical evidence should be made before deciding that it is absolutely necessary to intervene in the birthing process and the interdisciplinary team should ensure that intrapartum caregivers will “first do no harm.”
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spelling pubmed-62015312018-10-31 First do no harm - interventions during labor and maternal satisfaction: a descriptive cross-sectional study Çalik, Kıymet Yeşilçiçek Karabulutlu, Özlem Yavuz, Canan BMC Pregnancy Childbirth Research Article BACKGROUND: Interventions can be lifesaving when properly implemented but can also put the lives of both mother and child at risk by disrupting normal physiological childbirth when used indiscriminately without indications. Therefore, this study was performed to investigate the effect of frequent interventions during labor on maternal satisfaction and to provide evidence-based recommendations for labor management decisions. METHODS: The study was performed in descriptive design in a state hospital in Kars, Turkey with 351 pregnant women who were recruited from the delivery ward. The data were collected using three questionnaires: a survey form containing sociodemographic and obstetric characteristics, the Scale for Measuring Maternal Satisfaction in Vaginal Birth, and an intervention observation form. RESULTS: The average satisfaction scores of the mothers giving birth in our study were found to be low, at 139.59 ± 29.02 (≥150.5 = high satisfaction level, < 150.5 = low satisfaction level). The percentages of the interventions that were carried out were as follows: 80.6%, enema; 22.2%, perineal shaving; 70.7%, induction; 95.4%, continuous EFM; 92.3%, listening to fetal heart sounds; 72.9%, vaginal examination (two-hourly); 31.9%, amniotomy; 31.3%, medication for pain control; 74.9%, intravenous fluids; 80.3%, restricting food/liquid intake; 54.7%, palpation of contractions on the fundus; 35.0%, restriction of movement; 99.1%, vaginal irrigation with chlorhexidine; 85.5%, using a “hands on” method; 68.9%, episiotomy; 74.6%, closed glottis pushing; 43.3%, fundal pressure; 55.3%, delayed umbilical cord clamping; 86.0%, delayed skin-to-skin contact; 60.1%, controlled cord traction; 68.9%, postpartum hemorrhage control; and 27.6%, uterine massage. The satisfaction levels of those who experienced the interventions of induction, EFM, restriction of movement, two-hourly vaginal examinations, intravenous fluid, fundal pressure, episiotomy, palpation of contractions on the fundus, closed glottis pushing, delayed umbilical cord clamping, delayed skin-to-skin contact, fluid/food restriction, and of those who were not provided pharmacological pain control were found to be lower (p < 0.05). CONCLUSION: Medical interventions carried out at high rates had a negative impact on women’s childbirth experience. Therefore, a proper assessment in the light of medical evidence should be made before deciding that it is absolutely necessary to intervene in the birthing process and the interdisciplinary team should ensure that intrapartum caregivers will “first do no harm.” BioMed Central 2018-10-24 /pmc/articles/PMC6201531/ /pubmed/30355293 http://dx.doi.org/10.1186/s12884-018-2054-0 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Çalik, Kıymet Yeşilçiçek
Karabulutlu, Özlem
Yavuz, Canan
First do no harm - interventions during labor and maternal satisfaction: a descriptive cross-sectional study
title First do no harm - interventions during labor and maternal satisfaction: a descriptive cross-sectional study
title_full First do no harm - interventions during labor and maternal satisfaction: a descriptive cross-sectional study
title_fullStr First do no harm - interventions during labor and maternal satisfaction: a descriptive cross-sectional study
title_full_unstemmed First do no harm - interventions during labor and maternal satisfaction: a descriptive cross-sectional study
title_short First do no harm - interventions during labor and maternal satisfaction: a descriptive cross-sectional study
title_sort first do no harm - interventions during labor and maternal satisfaction: a descriptive cross-sectional study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6201531/
https://www.ncbi.nlm.nih.gov/pubmed/30355293
http://dx.doi.org/10.1186/s12884-018-2054-0
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